학술논문
Preventing tuberculosis in paediatric kidney transplant recipients: is there a role for BCG immunisation pre-transplantation in low tuberculosis incidence countries?
Document Type
Article
Author
Source
Subject
*TUBERCULOSIS prevention
*TUBERCULOSIS risk factors
*CHRONIC kidney failure
*IMMUNIZATION
*KIDNEY transplantation
*PEDIATRICS
*RISK assessment
*MEDICAL protocols
*BCG vaccines
*TRANSPLANTATION of organs, tissues, etc.
CHRONIC kidney failure complications
*
*
*
*
*
*
*
*
*
Language
ISSN
0931-041X
Abstract
The risk of tuberculosis (TB) disease is increased in children with chronic kidney disease (CKD), even higher in stage 5 CKD/kidney failure and especially high after kidney transplantation due to immunosuppression. TB disease may follow recent primary infection, or result from reactivation of latent infection. Reactivation is more common in adults, while progression following primary infection makes up a greater proportion of disease in children. Recommendations for preventing TB disease in some low TB incidence countries have previously included offering Bacillus Calmette-Guérin (BCG) vaccine to all children listed for kidney transplant if they had not received this as part of previous national immunisation programmes. Based on the available evidence, we recommend modifying this practice, focusing instead on awareness of risk factors for TB exposure, infection and disease and the use of appropriate testing strategies to identify and treat TB infection and disease. [ABSTRACT FROM AUTHOR]